Bopp C
Med Cutan Ibero Lat Am. 1976;4(4):285-92.
The author proposes a new method of treatment for chromoblastomycosis, using the association of two drugs of confirmed therapeutic activity: amphotericin B and 5-fluorocytosine. The aim was to obtain a synergistic action against the causative fungus. The method consists of the following: 50 mg. of amphotericin B is injected i.v. every other day --three times a week-- for three months. Total dosis: 36 ampoules. 5-fluorocytosine is simultaneously given orally --6 tablets of 500 mg. a day-- for three months in a total dosis of 540 tablets or 270 g. Seventeen patients were treated in this way up to now. Six interrupted the treatment on account of several reasons unrelated to treatment. The other 11 that completed this schedule, obtained clinical and histological cure. All were followed-up. No evidence of relapse was seen, even after 27 months of control. The safety of this method of treatment was demonstrated by the low incidence of side effects as inappetence, lassitude, nausea and weight loss. In these circumstances the discontinuance of the drugs for some days was sufficient to resume the treatment. Apparently this therapeutic schedule is the most effective up to now. It has the advantage of not causing resistance and by utilizing low concentrations of the drugs, protecting the patient against risks of toxicity.
作者提出了一种治疗着色芽生菌病的新方法，即联合使用两种已证实具有治疗活性的药物：两性霉素B和5-氟胞嘧啶。目的是获得针对致病真菌的协同作用。该方法如下：每隔一天静脉注射50毫克两性霉素B（每周三次），持续三个月。总剂量：36支。同时口服5-氟胞嘧啶（每天6片500毫克的片剂），持续三个月，总剂量为540片或270克。到目前为止，已有17名患者接受了这种治疗。6名患者因与治疗无关的多种原因中断了治疗。完成该疗程的其他11名患者获得了临床和组织学治愈。所有患者均接受了随访。即使在对照27个月后，也未见复发迹象。这种治疗方法的安全性通过副作用发生率低得以证明，如食欲不振、疲倦、恶心和体重减轻。在这些情况下，停药几天就足以恢复治疗。显然，这种治疗方案是目前最有效的。它具有不产生耐药性的优点，并且通过使用低浓度的药物，保护患者免受毒性风险。
